产前超声诊断经典膀胱外翻的价值  

Prenatal Ultrasound in Diagnosis of Classic Bladder Exstrophy

作　　者：黄君红[1] 杨小红[1] 陈欣林[1] 赵胜[1] 朱霞[1] 卢丹[1] 张莉[1] HUANG Junhong;YANG Xiaohong;CHEN Xinlin;ZHAO Sheng;ZHU Xia;LU Dan;ZHANG Li(Department of Ultrasonic Diagnosis,Hubei Maternal and Child Health Hospital,Wuhan 430070,China)

机构地区：[1]湖北省妇幼保健院超声诊断科,湖北武汉430070

出　　处：《中国医学影像学杂志》2018年第8期616-619,共4页Chinese Journal of Medical Imaging

基　　金：湖北省科技厅指导性计划项目(2014CKC1156)

摘　　要：目的探讨产前超声诊断经典膀胱外翻(CBE)的价值,提高CBE的检出率。资料与方法回顾性分析2013年1月-2017年10月于湖北省妇幼保健院就诊、经引产及出生后随访证实的7例CBE共9次产前超声图像,与产前MRI及出生后或引产尸检进行对比。结果 7例CBE中,产前超声确诊5例,漏诊2例,检出率为71.43%。5例CBE共行6次产前超声检查,其中膀胱未显影6例次,腹壁低位脐带5例次,耻骨联合分离4例次,小外生殖器或分辨不清4例次,脐下腹壁膨出物2例次。4例产前MRI证实超声表现,均探及脐下腹壁膨出物。结论产前超声能诊断CBE,但提供信息有限,其中膀胱未显影是主要表现。当发现胎儿膀胱异常时,需仔细探查胎儿腹壁、骨盆、脊柱等结构,必要时进行MRI检查,减少漏诊。Purpose To investigate the value of prenatal ultrasound in the diagnosis of classic bladder exstrophy(CBE),and to improve the detection rate.Materials and Methods A total of 9 prenatal ultrasound images from 7 CBE cases confirmed by induction of labor and postnatal follow-up in Hubei Maternal and Child Care Service Centre from January 2013 to October 2017 were retrospectively analyzed and compared with prenatal MRI and postnatal or post-induction autopsy.Results Among the 7 cases of CBE,5 cases were diagnosed by prenatal ultrasound and 2 cases were missed diagnosis,with a detection rate of 71.43%.For the 6 prenatal ultrasonography from 5 cases of CBE,undeveloped bladder,low-set umbilical insertion,separation of symphysis pubis,indistinguishable small external genitalia and umbilical lower abdominal wall protuberance were observed in 6,5,4,4 and 2 cases,respectively.The ultrasound findings were confirmed by prenatal MRI in 4 cases,in which umbilical lower abdominal wall protuberance was detected.Conclusion Prenatal ultrasound can diagnose CBE,but the information provided is limited,with undeveloped bladder as the main performance.When a normal bladder is not identified,the structure of fetal abdominal wall,pelvis,spine,etc.,should be carefully explored,and MRI can be conducted if necessary to reduce the misdiagnosis of CBE.

关 键 词：膀胱外翻 超声检查 多普勒 彩色 超声检查 产前 胎儿 

分 类 号：R714.53[医药卫生—妇产科学]